- Humana (Baton Rouge, LA)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical … more
- Humana (Indianapolis, IN)
- …to adapt and the courage to innovate **Additional Information** Reports to the Lead Medical Director - North Central Medicaid Markets. The Medical ... caring community and help us put health first** The Medical Director relies on medical ...Medical Directors will learn North Central region state Medicaid requirements (currently VA, KY, OH, IN, WI) and… more
- Humana (Tallahassee, FL)
- …first** * Candidate must be located in the State of Florida** The R-396181 Director Finance, Florida Comprehensive Medicaid (Florida Medicaid Market CFO) ... accurate and timely information for strategic and operational decisions. The R-396181 Director Finance, Florida Comprehensive Medicaid (Florida Medicaid … more
- Cognizant (Little Rock, AR)
- **About the role** **Schedule:** M-F **Traveling Required:** 40% As a Medicaid Eligibility Delivery Director , you will make an impact by overseeing access, ... wherever possible. Based on this role's business requirements, this is a remote position open to qualified applicants in United States. Regardless of your… more
- Commonwealth Care Alliance (Boston, MA)
- …at this time._** **Position Summary:** Working under the direction of the Sr. Director , TPA Management and Claims Compliance, Healthcare Medical Claims Coding ... for One Year Term **_This position is available to remote employees residing in Massachusetts. Applicants residing in other...7+ years of Healthcare experience, specific to Medicare and Medicaid + 7+ years progressive experience in medical… more
- OhioHealth (Columbus, OH)
- …Summary:** This position is responsible for preparing and reviewing the Medicare and Medicaid cost reports for all OhioHealth entities. * This position will be ... responsible for ensuring the appropriate governmental (Medicare and Medicaid ) reimbursement is received for OhioHealth. * This position is primarily responsible for… more
- Humana (Indianapolis, IN)
- …part of our caring community and help us put health first** The Indiana Medicaid Market CFO analyzes and forecasts financial, economic, and other data to provide ... accurate and timely information for strategic and operational decisions. The Director , Financial Planning & Analysis requires an in-depth understanding of how… more
- NTT DATA North America (Albany, NY)
- …adaptable, and forward-thinking organization, apply now. We are currently seeking a Senior Medicaid Solution Architect to join our team in Albany, New York (US-NY), ... Operations & Systems The Senior Solution Architect will report to the Technology Director for the Division of Operations and Systems and have responsibility for… more
- Magellan Health Services (Boise, ID)
- …After Hours coverage may be required. General Job Information Title Medical Director (Behavioral Health) - Idaho- Remote Grade 36 Work Experience - Required ... Seeking a licensed, board certified psychiatrist. This is a remote position and will require Idaho license. This position...activity (QIA) in collaboration with the clinical lead senior medical director , and quality improvement staff. May… more
- Evolent (Helena, MT)
- …in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... improvement, and clinical excellence. + **This position is 100% Remote and can be completed from any state. Multiple...per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to… more
- Centene Corporation (Salem, OR)
- …quality accreditation standards. + Actively practices medicine **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical ... implementation of performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals and policies… more
- AbbVie (Mettawa, IL)
- … of Federal Contracting, Regional Director of Federal Accounts, and Director of Medicaid Contracting, including their respective AEs, to enhance account ... that solve serious health issues today and address the medical challenges of tomorrow. We strive to have a...contracting, retention, and pull-through performance across the DoD, VA, Medicaid , IHS and Kaiser channels. + Manage Channel Directors… more
- Integra Partners (Troy, MI)
- The Senior Medical Director (Senior MD) serves as the clinical and strategic leader for Integra's Utilization Management (UM) and Credentialing programs. This is ... require. The Senior MD provides clinical oversight to the Utilization Review Medical Director (s), ensures consistent application of criteria, leads medical… more
- Stanford Health Care (Palo Alto, CA)
- …America) **This is a Stanford Health Care job.** **A Brief Overview** The Director of Reimbursement is a key leadership role within the Controller's Office, ... Department of Health Care Access and Information (HCAI) In addition, the Director of Reimbursement oversees the organization's responses to government audits and… more
- Humana (Helena, MT)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- Integra Partners (Troy, MI)
- The Utilization Review Medical Director is responsible for conducting clinical reviews of Durable Medical Equipment (DME) and related requests to support ... to workflow timelines, clinical accuracy standards, and productivity expectations. The Medical Director ensures determinations are made in accordance with… more
- Humana (Boise, ID)
- …home health, SNF, DME, dual Medicare/ Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether ... activities as assigned by the managing Medical Director Travel: While this is a remote ...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
- Humana (Charleston, WV)
- …home health, SNF, DME, dual Medicare/ Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether ... activities as assigned by the managing Medical Director ** Travel: While this is a remote ...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
- CVS Health (Springfield, IL)
- …**Position Summary** CVS Health, a Fortune 6 company, has an outstanding opportunity for a Medical Director - Medical Affairs (Oncology) We need a Board ... Certified Oncologist for this opportunity. This is a remote based from from home role. The Medical...development, Enterprise Analytics, Compliance, Legal, Accreditation) and clients. The Medical Director ( Medical Affairs) will… more
- Humana (Jefferson City, MO)
- …Become a part of our caring community and help us put health first The Medical Director actively uses their medical background, experience, and judgement to ... to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical … more